Question

What significance does the case of Internet-Based HIV/AIDS Education and Prevention Programs in Vulnerable Populations have regarding international collaboration for public health research? Explain your answer.

Answer 1

Youth remain at high risk for contracting and transmitting human immunodeficiency virus (HIV) and other sexually transmitted diseases (STD). In the U.S., over 5000 people under the age of 20 were diagnosed with HIV or AIDS from 2003–2006. Youth are also among those with the highest rates of STD, and having STD infection substantially increases risk for HIV acquisition and transmission. Recent reports indicate that Internet use by youth is now nearly universal, with 93% of teens using the Internet and spend an average of one hour on the computer daily. Computer-based efforts in HIV prevention show promise, and have the advantages of standardization, fidelity and likely ease of replication. However, they can have small samples. The Internet offers an additional opportunity to reach larger numbers of people in diverse settings. The privacy offered by computers and the Internet is also an asset, as is the accessibility to interventions from multiple sites (e.g., home, clinic, library). The standardization and ease of replication of computer-based interventions and the added potential benefits of reach and increased use of the Internet by youth, make both computers and Internet logical venues for HIV/STD research and prevention interventions.

There are both opportunities and challenges with online HIV prevention interventions. Various websites and programs such as PowerON, CyberReach, +Click (6;12;14) have been successful in harnessing the power of chat rooms, online forums and creating education spaces towards prevention. Some of the barriers and challenges that exist with offline HIV prevention behavioural interventions such as lack of adequate human resources, discomfort with facilitators and other facilitator issues, individual obstacles (transportation, insurance, physical limitations, the need for childcare) are addressed by online interventions.

Another thing the internet has changed how men who have sex with men (MSM) find and interact with sexual partners. This social phenomenon, paired with growing evidence that use of the Internet increases MSM’s risk for HIV infection, makes it crucial that innovative technology-based HIV prevention interventions are developed for this population. Since the early 2000s, studies have identified MISM as disproportionately at risk for acquiring HIV and other sexually transmitted infections (STI). Given the high usage of new media by MSM for sexual, social and community connections, and the increased risk for HIV associated with using the Internet for seeking sexual partners, the need to take advantage of new media technology as an intervention for HIV prevention in MSM is evident and critical. By doing online media such as encouraging use of condoms and safe sex practices, internet can be used to spread awarness among this high risk group.

Studies that test new technology interventions represent an exciting approach to HIV prevention, but in our experience need to be truly multidisciplinary and are quite difficult to do well. In particular, while recruitment is much easier, retention appears a critical challenge. Computer-mediated surveys have emerged, at least domestically, as the new gold standard for collecting socially sensitive information, while qualitative online studies are yielding rich data using multiple formats and platforms. The researchers should be encouraged to take on the challenge of new media research, because of the new opportunities it offers, and because the emerging science of e-Public Health holds such potential to significantly impact the spread of HIV locally and globally.